POSTCONCUSSION SYNDROME

A.

Postconcussion syndrome can result from relatively minor head injuries.

B.

Most commonly involves headaches, tinnitus, vertigo, gait unsteadiness, emotional lability, sleep disturbances, intermittent blurring of vision, and irritability.

C.

Symptoms can continue for weeks, months, or several years, but are rarely permanent.

D.

Of patients who suffer postconcussion syndrome, 90% have spontaneous resolution of their symptoms within 2 weeks of injury. Beta-blocking agents, tricyclic antidepressants, or nonsteroidal anti-inflammatory agents may be beneficial, as well as psychotherapy and physical therapy.

E.

For those with persistent symptoms referral to a brain rehabilitation specialist is necessary.

Axioms

• Loss of consciousness is an important indicator of brain injury.
• Determine the GCS score as early as possible.
• A principal therapeutic goal is to enhance cerebral perfusion and avoid further ischemic injury.
• Early diagnosis and evacuation of mass lesions are critical.
• CT scan is the diagnostic test of choice for patients with all brain injuries.